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RMU

Uruguayan Medical Journal

ISSN: 1688-0390


Vol.22 - Nº 1 - Mar. 2006

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Caustic esophageal injuries. Esophageal stenosis and its treatment with dilation

DELGADO L; ACOSTA A; IGLESIAS C; TANZI MN; SERENO V; ARMAS D; MENDEZ V; MONTANO A
Rev Med Urug 2006; 22: 46-51
Full text (spanish) |  Full text (spanish) (New windows, pdf) | Abstract

Abstract

Accidental ingestion of caustic substances during child-hood is frequent. Esophageal stenosis (EE) secondary to caustic esophageal injuries (EC) is a severe complication.

Endoscopic dilation with balloon was the selected treatment for EE. Most of the patients showed good responses but required reiterative dilations. Surgical treatment is needed when there is a fail of endoscopic dilation.

The study analyzes retrospectively the development of children with EC and the treatment of those who presented esophageal stenosis.

All children with EC admitted into the Endoscopic Service (Hospital Pereira Rossell) from January 1997 to December 2002. Ninety two patients were diagnosed with esophageal injuries.

The mean age was 2.8 years; 61 males.

The ingested substance most frequently was alkaline.

Types of EC were as follow: type I, 35 (38%); type IIa, 23 (25%); type IIb, 16 (17%); type IIIa, 10 (10.8%) and type IIIb , 8 (8.7%). Nine developed to stenosis (two with esophagitis type IIb, two with type IIIa and five with type IIIb injury). Overall dilations were 168 (mean 18.6): five children did not need dilations, two are still under treatment and two children were assigned to surgery (mean follow up: 10.5 months).

Although the study population was small, we concluded that moderate and severe EC (type II and III respectively) developed more frequently to stenosis, balloon treatment was suitable and the number of complications was low.

Prevention measures are highlighted.